Provider Demographics
NPI:1821061219
Name:BORRELLI, LINDA F (DC)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:F
Last Name:BORRELLI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 LOWER MAIN ST
Mailing Address - Street 2:P.O. BOX 484
Mailing Address - City:CALLICOON
Mailing Address - State:NY
Mailing Address - Zip Code:12723-5148
Mailing Address - Country:US
Mailing Address - Phone:845-887-4485
Mailing Address - Fax:845-887-5473
Practice Address - Street 1:25 LOWER MAIN ST
Practice Address - Street 2:
Practice Address - City:CALLICOON
Practice Address - State:NY
Practice Address - Zip Code:12723-5148
Practice Address - Country:US
Practice Address - Phone:845-887-4485
Practice Address - Fax:845-887-5473
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX006747-1111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX59012OtherEMPIRE BC/BS
NY98L1181OtherLANDMARK
NY0044009OtherGHI/PPO
NY0044009OtherGHI/PPO
NY98L1181OtherLANDMARK